In July 2020, he went to see his doctor with what he thought was a niggling hip injury. Scans were ordered and then pathology tests and after several weeks of investigation, Will was shocked to be diagnosed with prostate cancer.

“I don’t drink or smoke and I exercise like a bit of a maniac! I’d never felt fitter so the diagnosis was a shock, it didn’t make sense to me. My dad had been diagnosed with prostate cancer just 6 months before in his early 70s but otherwise I had no family history,” he said.

“I think there’s a general sense of ‘it won’t happen to me’ amongst men. Unfortunately, I’m proof that it could happen to you. I know some men are scared of the physical examination but they should know that to get checked the first step is a blood test, and you may not even need a physical exam. There’s so much you can’t control with your health, so it’s important to take action on what you can.”

Pathology Awareness Australia invited Will inside the pathology laboratory in Adelaide where his cancer was diagnosed. He was accompanied by Tim Stollznow a prostate cancer survivor and ambassador for the Prostate Cancer Foundation of Australia.

Chemical Pathologist, Dr Devika Thomas explains PSA testing to news reporter Will McDonaldTim was diagnosed with prostate cancer in 2016, aged 50. In contrast to Will’s story, Tim had been getting regular Prostate Specific Antigen (PSA) tests because his father and grandfather had both had prostate cancer, so he knew he was at higher risk and had discussed this with his doctor.

He was diagnosed after a biopsy in 2016 and was fortunate to catch the cancer at an early stage. At first Tim chose to have regular monitoring tests but when his PSA level began to rise he was referred for another biopsy which showed the cancer was progressing. Tim had surgery to remove his prostate in 2017 and says life now is pretty much back to normal;

“You look at life a little differently when you’ve had cancer, it takes a while to come to terms with, you don’t think about it day to day but sometimes you do reflect on it, maybe when you’re walking on the beach,” he said.

Both Will and Tim were impressed and fascinated by what they saw in the pathology laboratory and Will was also able to see his own biopsy slides under the microscope.

Tim believes education in the community is key to fighting prostate cancer;

“We’ve got a lot of work to do as a society in creating awareness of prostate cancer. I was lucky that I knew my grandad had prostate cancer. There are plenty of instances of men back in the 1970s, 80s and 90s who had prostate cancer but didn’t talk about it. When I first heard of prostate cancer I didn’t know what it was, where the prostate was. I think it’s so important to talk about.”

Professor Jeff Dunn AO, CEO of the Prostate Cancer Foundation of Australia (PCFA) urged Australians to learn more about prostate cancer risk factors, and about the prevalence of the disease.

“Community awareness is key to beating prostate cancer. Many Australians don’t know the risk factors for prostate cancer, such as age and family history. If you have just one direct male relative who has had the disease, your risk doubles,” said Prof Dunn.

PCFA has recently launched their STARGATE data portal where anyone across Australia can search using their postcode for prostate cancer data for their region.

You can see the Channel 9 news coverage of the story here:

The post Nine news reporter sees his cancer up close first appeared on Know Pathology Know Healthcare.

Members of the LGBTQI+ community can face additional barriers to accessing a Cervical Screening Test and there are concerns the pandemic will have made attendance rates worse in this cohort. Misunderstandings also persist within the community about who is at risk of the Human Papillomavirus (HPV), the virus that causes the majority of cervical cancers.

Associate Professor Julie Mooney-Somers, an LGBTIQ+ health researcher at the University of Sydney said;

“HPV is present in 93% of all cervical cancer cases. Some people think that if there is no penis involved in sex then there’s no risk of contracting or transmitting HPV. Unfortunately, that isn’t the case because HPV is spread by skin-to-skin contact (that means by your hands, mouth and genitals) and through sharing sex toys. You need to be tested even if you have never had sex with a man or if your partner has never had sex with a man. All women and people with a cervix need to be tested; cervical cancer does not discriminate. Rates of smoking are higher among LGBTQI+ people, which increases the risk of cervical cancer, so testing is even more important.”

The Cervical Screening Test detects HPV, giving an opportunity for intervention to prevent cancer from developing. Positive HPV samples are also examined under a microscope by the pathology team in the laboratory to check if changes that could lead to cancer are already present. This provides the chance for early treatment and better health outcomes.

Dr Maryam Shamassi, a gynecological pathologist said:

“Cervical screening, like any other screening test, is intended to detect abnormalities which, if left undetected and untreated, can develop into cervical cancer. With the new cervical screening program, which was introduced in Australia in 2017, a five yearly HPV test has replaced the traditional two-yearly Pap smear. Testing less often makes it easier on patients but more important not to miss a test.

“HPV is short for human papillomavirus, a family of more than 150 related viruses, some of which are known to cause cancer, including cancers of the cervix, vagina, vulva, penis, anus, and parts of the mouth and throat. HPVs live only in certain cells called squamous epithelial cells which are found on the surface of the skin and on moist surfaces called mucosal surfaces. The Cervical Screening Test looks for cervical infection by high-risk types of HPV that are more likely to cause pre-cancers and cancers of the cervix. So if you have a cervix, make a note to yourself to get a CST, it’s a straightforward test that could save your life!”

Data from a recent Sydney Women and Sexual Health (SWASH) study shows lesbian, bisexual and queer women who have never had sex with a man are a lot less likely to have had a Cervical Screening Test.

Kate’s cervical cancer story

Kate, a Police Detective based in Moree, New South Wales, was diagnosed with cervical cancer in April 2019 at just 31 years of age. Kate and her wife were planning to start a family at the time. During the IVF process, they realised they were both 12 months overdue for their Cervical Screening Tests. During Kate’s screening, a tumour was found, and after a biopsy, she received the tragic news that she had cervical cancer.

“I was not expecting [the diagnosis] because I was healthy, I didn’t have any symptoms and I’d previously been up to date with my screenings. My wife and I had recently gotten married, life got in the way and I put it off. When we received the news that I had cervical cancer all I kept thinking about was my fertility and how I wouldn’t be able to carry the baby, in that moment it didn’t cross my mind that I may not survive. The scary thing is, if I had waited another six months I could have been in a completely different situation, my diagnosis could have been far worse than what it was.”

Kate had a radical trachelectomy, a form of surgery that completely removes the cervix. Nine pelvic lymph nodes were also removed for biopsy. Unfortunately, one of those pelvic nodes showed a small deposit of cancer. This meant cancer had spread, and Kate needed to receive chemotherapy and radiotherapy.

“I was really devastated about the robbing of my fertility as well as having cancer. It was just one blow after another.”

Prior to the chemotherapy and radiotherapy, Kate was able to undergo one round of IVF.

“I was determined to somehow create life. I went through the whole process and ended up getting one viable embryo, which was a miracle given everything my body was going through. There wasn’t a big chance that a successful pregnancy could happen from just one healthy embryo, but we put it on ice while I went through my gruelling cancer treatment.

I finished the treatment in August 2019 and then in November 2019, my wife underwent the IVF transfer procedure. Amazingly it took, and in August of last year we welcomed our little baby girl Zoë into the world. She’s here now and she’s eight months old, and she’s a perfect little person. Despite all the odds being against us, this little bit of goodness came out of such a horrible time in my life. We called her Zoë because Zoë means ‘life’ in Greek and I believe wholeheartedly that she actually did save my life.”

Kate is an ambassador for the Australian Cervical Cancer Foundation and her message to women in the LGBTQI+ community is the value of prevention and early detection;

“There are so many ways that you can treat things when they are caught early, that you just can’t do down the track. We in the LGBTQI+ community need to look out for each other. Check in on your friends and your girlfriends and others in your community and speak up and normalise the Cervical Screening Test. Normalise health and following-up with one another, be vocal about it. Take it from me, a five-minute screening test is nothing compared to having your cervix removed, so please make sure you are up to date. I hope that my message encourages others out there to get checked. I obviously still wish that I didn’t get cancer but hopefully some good can come out of it if people act on my story and hear my message.”

All women, and anyone with a cervix, aged between twenty-five and seventy-four are eligible for a CST every five years, but the figures show that many are overdue for testing.

Elizabeth Ham, National Health Promotion Manager at the Australian Cervical Cancer Foundation (ACCF) urges people to check their eligibility and when they might be due for a test;

“The pandemic has caused so many different disruptions in our lives but now is the time to put our health first. If you think you might be due or overdue for a Cervical Screening Test, do not delay in making an appointment with your healthcare provider. Remember if you have a cervix, you need to have regular Cervical Screening Tests.”

Cervical cancer and screening resources and further information

When it comes to collecting a sample for a cervical screening test, some may find the process confronting and it is worth noting that there are specific services designed to be LGBTQI+ friendly.

Clinic locations and further information is available at https://www.theinnercircle.org.au/.

The Inner Circle also have a useful resource which LGBTQI+ people can use to address fears and barriers to testing at their preferred healthcare provider, download the letter to your GP here.

ACON provide a TransHub’s Gender Affirming Doctor List which outlines LGBTQI+ clinicians across New South Wales for those outside of urban locations.

Trans[TEST] at Kirkton Road Centre, NSW, and Equinox on Hoddle Street, Abbotsford, Melbourne, provide Cervical Screening Tests for trans and gender diverse people.

The post ‘We in the LGBTQI+ community need to look out for each other’, calls to catch-up on missed Cervical Screening Tests first appeared on Know Pathology Know Healthcare.

Find out if you need a test

In November 2017, the National Cervical Screening Program updated the two-yearly ‘Pap Smear’ to the five-yearly Cervical Screening Test, an improved version which tests for the Human Papillomavirus (HPV), a virus present in most cases of cervical cancer. This test allows for earlier detection of changes that could lead to cancer.

The Cervical Screening Test is recommended for all women aged 25–74, every five years. If you had your last Cervical Screening Test before November 2017, you are now overdue. Please speak with your healthcare provider if you believe you are eligible for the Cervical Screening Test.

HPV and cervical cancer are usually asymptomatic, particularly in the early stages. Women who have symptoms such as abnormal bleeding should talk to their doctor right away.

The post What happens to your cervical screening test? first appeared on Know Pathology Know Healthcare.

How has healthcare been different for you during lockdown?

During lockdown, I was able to have phone consultations or telehealth appointments with both my GP and my gynaecologist.

A year ago, I had my first surgery for irregular cervical cells following on from my Cervical Screening Test and it was there I found out that I had AIS (Adenocarcinoma in situ – a precancerous condition) and SIL (squamous intraepithelial lesions – abnormal cells on the cervix) . Thankfully, after the second surgery, I received clear margins and was required to have my six-month check-up in June of this year. It was a slightly different experience to normal, as we all had to wear masks and when I had my blood test and cervical scan, that was the same procedure required. I had purchased a face mask from the chemist for my first appointment and at the second appointment, I was provided with a mask.

I feel that the healthcare I received was exceptional for the circumstances of COVID-19, but I’m glad that I did still connect with the medical professionals who have been looking after my journey whilst both in lockdown and with some restrictions. I’m glad that I didn’t delay my appointments or put off making them due to the circumstances. I also had a psychology video consultation in April and that was a huge help as well.

If I can urge anyone to do something this year, it’s to ensure that you stay on top of your regular check-ups. I put off my Cervical Screening Test for too long and I am so grateful that my body at the time gave me some warning signs, your health truly is your wealth.

How have you overcome any barriers to healthcare?

I overcame barriers by communicating with my medical professionals, sending an email or making a phone call to book an appointment and discuss what my best options were. For some appointments, they would be done via phone, and others had to be in person.

What would be your advice to other patients on managing their health during lockdown?

My advice to patients on managing their health during lockdown would be to make sure that you listen to your body, ensure that your medical appointments are up to date and don’t put off important appointments. My next medical appointments to make will be my annual breast-screening, mole scan and dermatologist appointment and also with my dentist and optometrist before the end of the year.

I am planning on keeping all of my medical appointments in a hard copy diary next year, so I am more organised than ever. I currently rely on my memory and my phone or email and SMS updates for my reminders. My Health Record is also very helpful.

You can read more about Rachael’s story here

The post The face behind the mask – meet the patient first appeared on Know Pathology Know Healthcare.

The Medicare Benefits Schedule (MBS)² data indicates in March 2020, when COVID-19 restrictions began, testing numbers dropped to almost half the number performed the previous year.

Although test numbers were expected to drop this year with the program changing from a two-yearly to a five-yearly test, the number of women having their test is still much lower than anticipated³.

In November 2017, the National Cervical Screening Program (NCSP) changed to test for the Human Papillomavirus (HPV), a virus present in most cases of cervical cancer. This test allows for earlier detection of changes that could lead to cancer and so is recommended every five years.

The MBS data reveals that only 174,000 women had a CST from March 2020 to June 2020, when COVID-19 restrictions were in place. This figure is dwarfed by the half-a-million tests that were performed during the same period in 2019.

Adjunct Professor Annabelle Farnsworth, pathologist and Medical Director at Douglass Hanly Moir Pathology, and Director of Cytopathology and GynaePath, said;

“Nearly all cases of cervical cancer are caused by an infection with HPV. In most cases an HPV infection shows no symptoms and that is why regular screening tests are so important. Sadly, cervical cancer is a cancer of young women, so it’s vital that women have their tests from the age of 25. There is no doubt early detection saves lives. Australia was on track to eradicate cervical cancer by 2035 and we want to ensure we achieve that goal.”

“We expected a drop in testing this year due to the new program changeover, but at the beginning of the pandemic we saw a drop in pathology testing across the board, and we have not seen the numbers of CSTs increasing to show that missed tests are being rectified. We do not know when the pandemic will be over so it is important that people understand they cannot put their CST on hold indefinitely. Measures are in place to ensure people can catch up on their screening safely during the COVID-19 pandemic.”

A study by Cancer Council NSW⁴ predicted that disruptions due to COVID-19 would result in between 270,000 and 1,000,000 women missing a screening test in 2020.

Gold Coast mum Bec Gear (34) is a passionate advocate for cervical cancer awareness. She put off her CST for 12 months while in the process of moving back to Australia from New Zealand, and was later treated for cervical cancer;

Ms Gear said: “I was due for my test when living in New Zealand and I decided to wait until I was back in Australia. When I got back, I found other excuses to put it off but eventually a post I saw on social media prompted me to go and get tested. I was lucky that I caught the cancer at an early stage, I shudder to think how bad it could have been. It really worries me to see how many women have missed their CST this year. I understand that we are living in a pandemic, but cervical screening could save your life.”

“If you have never had a CST before or if you are overdue to have one, now is the time to catch up and get it done. Talk to the other women in your life about it too, that simple reminder could save someone you love.”

According to a recent study by the University of Melbourne⁵, the number of women aged 18 to 44 who needed to see a healthcare professional but chose not to has been on the increase.

At the beginning of June 2020, 18.3% of women in that age group who needed to see a healthcare professional chose not to. This rose to 20.2% in late June 2020, and further increased to 22.2% in August of this year.

This is a worrying trend and is also a missed opportunity for healthcare providers to remind women about cervical screening and check they are up to date.

Joe Tooma, CEO of the Australian Cervical Cancer Foundation (ACCF), said:

“In a normal year, around 46% of Australian women are not up to date with their cervical screening. We all know that 2020 has not been a normal year so that drop in screening has been amplified. Many people may not be aware that cervical cancer can affect younger people, we hear many stories like Bec’s from women in their twenties and thirties who have delayed their screening tests.

This is why cervical screening is offered between the ages of 25 and 74. Women in that age group who have not had a CST in the last two years are now overdue, so it’s time to catch up, make an appointment and get a CST.”

Image credit: Nigel Hallett / The Courier Mail

References

1. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930183-X/fulltext
2. http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=PN.0.22&qt=noteID&criteria=cervical%20screening
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845438/
4. https://www.health.gov.au/resources/publications/modelled-analysis-of-hypothetical-impacts-of-covid-19-related-disruptions-to-the-national-cervical-screening-program
5. https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0007/3478633/ri2020n23.pdf

The post COVID disruption leaves Australia’s cervical cancer goals hanging in the balance first appeared on Know Pathology Know Healthcare.

According to news delivered on the show earlier this month, Kim Kardashian West’s blood had tested positive for “lupus and rheumatoid arthritis antibodies”. However, a subsequent episode revealed that her symptoms of tiredness and swollen hands were actually due to psoriatic arthritis.

So, what are these autoimmune conditions and why the confusion?

Systemic Lupus Erythematosus usually known as lupus or SLE is a condition that affects more women than men – eight times more in fact.² It is a chronic, inflammatory autoimmune disorder that can affect several organ systems including the kidneys, skin, joints and other internal organs.

Lupus usually begins in one organ but can progress to involve others. Possible symptoms that may be experienced include: joint pain; fatigue, headaches and a skin rash – which often manifests in a butterfly shape across the nose and cheeks. In rare cases serious symptoms can occur such as seizures, psychoses, inflammation in the heart and lungs, and blood clots that could lead to a stroke or pulmonary embolism.

Rheumatoid arthritis is a chronic autoimmune condition affecting around 450,000 Australians.³ It affects the joints when your immune system malfunctions and attacks healthy tissue in or near your joints. Common symptoms include swelling, pain and heat in the joints, joint stiffness and persistent fatigue.

Psoriatic arthritis causes inflammation of the joints which can result in pain, swelling and stiffness in the joints, pain in tendons and thickening or colour changes in the nails. It affects people who have psoriasis and but only between 10 and 30 percent of people with psoriasis will develop this type of arthritis.

What did Kim’s ‘positive’ lupus result mean?

Diagnosing autoimmune conditions like lupus can be complex. Immunopathologist Associate Professor Stephen Adelstein explains:

“People sometimes think that a test alone can diagnose a disease, but it can’t. We must look at a patient’s symptoms, a comprehensive medical and family history, as well as pathology results to understand what is causing the problem.

Results from a range of tests are often needed to reach a diagnosis, particularly when symptoms are similar across several conditions.”

The pathology tests we have available for autoimmune conditions look for clues in the blood that tell us about certain body processes that are happening.

For example, the antinuclear antibody (ANA) test is often ordered by doctors if they suspect lupus. ANAs are a group of special antibodies produced by the patient’s immune system when it malfunctions and cannot tell the difference between ‘self’ and ‘other’. They are known as autoantibodies and can attack the body’s own cells, causing symptoms such as tissue and organ inflammation, joint and muscle pain, and fatigue.

Detecting ANA in the blood shows that an autoimmune process is taking place. The ANA test is most commonly used to indicate lupus but is also associated with other autoimmune disorders. However, a positive result can happen in some people without an autoimmune condition and this is more common as we age, with 30% of women and 20% of men being ANA positive by age 70.⁴

In pathology this is known as a test that is highly sensitive but not highly specific. This means the test is able to pick up close to 100 per cent of people who have the autoantibodies in their blood, but cannot specify that they have lupus, because someone who does not have lupus may still have a positive result.

For this reason, after a positive ANA result, doctors will often order an Anti-dsDNA test that is a more specific test to confirm a lupus diagnosis. We don’t know what tests were ordered in Kim’s specific case, but it certainly highlights the complexities of diagnosing autoimmune diseases.

A/Prof Adelstein says; “This is a constantly evolving area. We are always looking for ways to improve the diagnostic ability of the tests we have and to develop new tests that can be more specific and more sensitive so that patients can be diagnosed and treated more quickly.”

References

1. https://www.allergy.org.au/patients/autoimmunity/systemic-lupus-erythematosus-sle
2. https://www.labtestsonline.org.au/learning/index-of-conditions/lupus
3. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis/contents/who-gets-rheumatoid-arthritis
4. https://www.labtestsonline.org.au/learning/test-index/ana

The post Kim Kardashian’s blood test results explained first appeared on Know Pathology Know Healthcare.

Olympic athlete and Commonwealth Games gold medallist Jana Pittman was diagnosed with a precancerous condition of the cervix whilst having IVF treatment in 2015. Pittman is now studying to become a doctor and wants to specialise in gynaecology.

Pittman visited a pathology laboratory to see how the Human Papilloma Virus (HPV) and cervical cancer are diagnosed. She is an advocate for women to participate in cervical screening, saying;

“I had put off getting tested for quite a few years, not because I didn’t want to be tested but because I was busy and hadn’t prioritised it. I want all women to take part in the screening program, it’s just five minutes and a bit of discomfort to get tested and get that peace of mind.”

More women should participate in the improved cervical cancer screening program to eliminate the disease. The latest data from the National Cervical Screening Program reveals that the new testing system introduced in December 2017 is working well but screening participation rates must increase.

The new test replaces the previous pap smear test – it is more sensitive and detects the the HPV which can cause changes in the cells of the cervix that may later lead to cancer.

The test is capable of detecting an HPV infection many years before a pap smear could find any changes in cells.

The HPV vaccine was introduced in Australia in 2007 and is now offered to teenage girls and boys as part of a school-based vaccination program to protect against strains of the virus that can cause genital warts and several types of cancer, including cervical cancer.

There are over 100 strains of HPV, with 15 strains known to be associated with cancer. The most recent vaccine protects against nine strains of HPV; seven of these can cause cancer and two are linked to genital warts.

The sample for pathology testing is collected in the same way as the previous pap test via a vaginal examination and cervical swab.

Data from the first six months of the new screening program found that a greater number of women were referred for colposcopy, a follow-up examination from an abnormal result, than with the previous pap smear testing system.

Estimates before the program began had predicted an increase in colposcopies, but the rate of referral was about three times higher than expected.

The study, published in Medical Journal Australia (MJA), analysed data from over 150,000 cervical screening samples received in the first six months of the new program.

Key findings were:

• Rates of any cancer-causing HPV were highest in women in the youngest age group of 25–29 years;
• Prevalence of the highest risk HPV types 16 and 18 peaked in the 30–34 age group;
• This age group had the highest number of women classified as ‘high risk’.

Adjunct Professor Annabelle Farnsworth is one of the paper’s authors and a leading expert in the field. She pointed out that many young women will not be aware they are still at risk of developing cervical cancer even though they have been vaccinated.

“The vaccine is very good, and we are lucky to have it in Australia. However, the early HPV vaccine only protected against four types of the virus, two of these are high-risk types. Even people who were vaccinated can still be at risk from other types of HPV. And of course, not all women have been vaccinated, which means it’s really important that every woman takes part in testing. If you have a negative result, you get peace of mind and you don’t need to be tested again for five years.”

According to the Australian Institute of Health and Welfare (AIHW) the participation rate for cervical screening in 2015–2016 was 56%.

A recent survey by the Australian Cervical Cancer Foundation (ACCF) looked at the reasons why women do not participate in screening. They found that over a quarter (26%) of women listed embarrassment and a third (32.3%) listed awkwardness as their reasons to avoid booking appointments for tests.

“Our national research demonstrates that whilst we, as a nation, have made significant gains when it comes to HPV vaccination rates and driving down new cases of cervical cancer, misunderstanding of cervical cancer and of the cervical screening test is rife. It’s imperative therefore that we not only act but react to the new research,” said Joe Tooma, CEO, ACCF.

Adj. Prof. Farnsworth said that women may be put off screening for a range of reasons. To support these women to take part in screening, a self-collect option is now available to eligible women under the new HPV testing system.

“Many women are not aware of the option for self-collection, meaning they can use a swab given by a health professional to collect their own sample in private whilst at the clinic. This may help women who would otherwise not be tested for all sorts of reasons, so we want to encourage women to talk to their GPs or health providers about this option,” said Adj. Prof. Farnsworth.

Adj. Prof. Farnsworth also wants women to be aware that this is a cancer that affects the young;

“HPV transmission typically starts when sexual activity begins and so a persistent infection may start to cause problems in 10–15 years when a woman is still young. The good news is that early detection leads to faster treatment of HPV, a precancerous condition or cancer itself. Women are often able to live a normal healthy life after treatment, including having children.”

According to a study in The Lancet medical journal, Australia is on track to eliminate cervical cancer by 2035. Australians (particularly those working in pathology) should be proud that we are so close to achieving this, however, to get there we must continue to strongly encourage participation in both vaccination programs and cervical screening tests.

The post Olympic athlete Jana Pittman learns about pathology and cervical cancer first appeared on Know Pathology Know Healthcare.

The Honourable Jim Lloyd, a former Howard Government Minister who served in Parliament from 1996 to 2007 was diagnosed with prostate cancer in 2002. Following his own diagnosis, he is now an advisor for Prostate Cancer Foundation of Australia (PCFA).

With a family history for the condition, Mr Lloyd values the diagnosis process that has helped so many men, not only in his family, but also all across Australia.

Mr Lloyd was joined by the CEO of PCFA Professor Jeff Dunn for the tour around a pathology laboratory in Macquarie Park, to learn about how prostate cancer is diagnosed.

Prof. Dunn says that early detection is an important part of the conversation and seeing the inside of the “engine room” of healthcare was an eye-opener. He is grateful to the pathologists of Australia, acknowledging that the advances in prostate cancer control would not have been possible without the pathology labs and their hard work.

Next month, Pathology Awareness Australia will be hosting the 3^rd PSA Testing Event at Parliament House. Members of Parliament, Senators and their staffers will have the opportunity to receive a PSA test, and learn more about the role of pathology in prostate cancer diagnosis.

The post From Parliament to Pathology – Jim learns about Prostate Cancer Diagnosis first appeared on Know Pathology Know Healthcare.

The Sunshine Coast nurse and mother of two was diagnosed with bowel cancer in 2018 at just 38 years old.

“We are lucky that we live in a country where we have these tests available, so people really need to take part in screening, and listen to their body if something isn’t right.”

Ms Kriel was referred for a colonoscopy when she experienced stomach cramps and bloating.

“They removed two polyps from my bowel and pathology testing confirmed there was cancer present in one of them, it was so small a CT scan would have missed it. My surgeon said I am an ‘unlucky, lucky person’ because I was healthy and had no risk factors for bowel cancer, so I was lucky that the cancer was caught early.”

A study published in the May edition of The Lancet showed bowel cancer cases in people under 50 have risen in the last 10 years.¹

Pathology Awareness Australia ambassador, Dr Nick Musgrave is an anatomical pathologist who specialises in gastrointestinal pathology:

“With the data showing an increase in bowel cancer in younger Australians, anyone with symptoms should talk to their doctor. However, cancers can develop over several years and at the early stages may have few or no symptoms. That’s why it is important people take part in the screening program from the age of 50, to have the best chance of catching cancer early,” said Dr Musgrave.

Bowel cancer is Australia’s second biggest cancer killer, yet the 5-year survival rate for stage I bowel cancer is 99% and stage II is 89%.

For stage IV bowel cancer (metastatic cancer) the 5-year survival rate is just 13%.²

Ms Kriel’s cancer was at stage I and had not spread. She had surgery to remove half her bowel but was able to avoid radiation and chemotherapy after surgery.

“My bowel will never be the same, but chemotherapy is very gruelling and I was really worried about this when I was first diagnosed because it would mean prolonged illness and being away from my family. The psychological toll and financial burden of a cancer diagnosis and treatment is huge, especially for a younger person, you have your mortality thrown in your face.”

Despite this, a report released this month by the Australian Institute of Health and Welfare (AIHW) ² shows bowel cancer screening participation rates are worryingly low, just 41% in 2016-2017. And the participation rate was very poor (30%) in the younger age group, 50-54 years.

Dr Musgrave has called the numbers “astounding”.

“When you consider that bowel cancer in its early stages has a high survival rate but with late stage bowel cancer the survival rate is pretty dreadful, it is astounding that more people are not having the test. This is one of the cancers that we are able to screen for, so we must do everything we can to reduce the risk of having advanced disease,” said Dr Musgrave.

Under the National Bowel Cancer Screening Program, Australians aged 50-74 are sent testing kits in the mail to collect a faecal sample that is then posted to a pathology laboratory to be examined.

“I’ve turned 50 this year myself, and I know there’s an ‘ick’ factor with the test, but some people make too big a deal of having to sample their own faeces and may not realise that the test is actually pretty simple,” said Dr Musgrave.

“We know that participation rates for both cervical and breast cancer screening are much higher. The bowel cancer test is free of charge, is non-invasive and you don’t need to leave the house to collect your sample, when you weigh that against the potential impact of advanced cancer the number of Australians getting tested is far too low.”

Sally hopes her story will raise awareness of bowel cancer and encourage more people to take part in screening:

“I’m sure if we offered to turn back time for every bowel cancer patient to have early screening and an early diagnosis – they would take the opportunity in a heartbeat. The later the diagnosis, the more invasive the treatment needs to be, and the lower the survival rate.”

References

2. https://www.thelancet.com/journals/langas/article/PIIS2468-1253(19)30147-5/fulltext
3. https://www.aihw.gov.au/reports/cancer-screening/national-bowel-cancer-screening-program-monitoring/contents/table-of-contents

The post Low screening rate “astounding” in light of increased bowel cancer cases first appeared on Know Pathology Know Healthcare.

Unlike most patients who have been through cancer treatment, Vincent Jenkins has seen inside the laboratory where his diagnosis happened.

At the Melbourne Pathology laboratory that diagnosed his prostate cancer, Vin was able to get a close look at his own prostate biopsy slides and meet with Dr Peter Nguyen, the pathologist whose diagnosis led to life-changing surgery.

Eleven years ago, Vin went to his GP for an annual check-up, and was recommended to have a PSA blood test and have his prostate checked.

Prostate cancer is the most commonly diagnosed cancer in Australian men, and 100% of all cancers are diagnosed in pathology labs.

After surgery to remove his prostate, Vin has been in remission for 11 years. A keen golfer, he now lives an active lifestyle after his most recent brush with cancer.

Inside the lab Vin was able to learn how a biopsy examined by Dr Nguyen saved his life – and to meet Dr Nguyen for the very first time.

“This first test indicated that things were not normal, and I was told to come back in 6 months to see how things had progressed. It was then that we found that the situation had deteriorated.”

“I had never thought about having prostate cancer or even having a test,” said Vin, “that’s the scary thing – I had no symptoms whatsoever. I was asymptomatic, which is why I was so surprised to get back such high PSA test results.”

“After that my urologist suggested I have biopsies to check out my prostate. I was then diagnosed with prostate cancer and I was booked in for surgery about four weeks later,” said Vin, who retired from a career in marketing and advertising some years ago.

Anatomical pathologists like Dr Nguyen are the doctors who examine body tissue samples, such as Vin’s prostate biopsy, to diagnose disease and advise the medical team about treatment, as well as giving the all clear after successful surgery or therapy. Australia’s pathology sector boasts some of the highest quality standards in the world.

“The pathology is interesting to me, because after my prostate was removed, I was concerned that the cancer wasn’t confined to the prostate. However, the pathology tests confirmed that it was, which was a huge relief,” said Vin.

The 5-year survival rate for prostate cancer is 95%, however if cancer spreads to other parts of the body it is harder to treat.

Prostate Cancer Foundation of Australia CEO, Professor Jeff Dunn AO said:

“Regular health check-ups help with early detection, which is crucial in effectively fighting prostate cancer. Men over the age of 50 – or 40 if they have a family history of prostate cancer – need to talk with their GP about prostate health. If you fit the criteria, speak to your GP and remind your loved ones and friends to as well.”

Each year in Australia, approximately 20,000 men are diagnosed with prostate cancer and around 3,500 die of the disease, meaning early diagnosis is crucial to save lives.

“That’s why we need to encourage men over 50 to have regular tests done. If you don’t have symptoms, you can still have cancer. And the most important thing is to catch it early, like I did,” said Vin.

The post Prostate cancer survivor meets the doctor that diagnosed him 11 years ago first appeared on Know Pathology Know Healthcare.